Insulet's Omnipod DASH is now officially available in the United States. The Omnipod DASH™ System combines a tubeless, waterproof, wearable Pod that provides up to 72 hours of non-stop insulin with an easy-to-use, touch-screen, Bluetooth®-enabled Personal Diabetes Manager (PDM) that looks like a normal smartphone. The Pod can be worn anywhere you would administer an injection. Placement is easy, completed with the touch of a button and without even seeing a needle. The DASH system is available with limited release right now, and Healthy Living anticipates providing the system at the end of this year or early in 2020.

There are two components to the DASH system.

The Pod:

The Pod is a small, waterproof device that you fill with insulin and wear directly on your body.

The Pod includes a small, flexible cannula that inserts automatically with the push of a button.

The Pod communicates wirelessly with the Personal Diabetes Manager (PDM) to program insulin delivery.

The Personal Diabetes Manager (PDM):

Multiple PDM features support how you control your insulin.

The system includes two mobile apps and accompanying widgets.

Compatibility with other systems simplifies the tracking and recording of data.

Updated PDM (Personal Diabetes Manager) – The handheld portion of the Omnipod Insulin Management System got an update and will feature a color touchscreen display.

Bluetooth wireless technology – DASH™ PDM and Pod will communicate via Bluetooth, laying the groundwork for current and future integrations with compatible technology – like meters, CGM, and management apps.

Meter integration – DASH™ will be optimized for use with CONTOUR® NEXT ONE Blood Glucose Meter for the transfer of blood glucose readings to the PDM’s bolus calculator via Bluetooth – The PDM will no longer have a built-in BGM.

Diabetes management app integrations – The Omnipod Display and Omnipod View apps will provide users and their caregivers easy access to their insulin therapy information on their smartphones.

Omnipod DISPLAY allows users to discreetly monitor their PDM data on their smartphones.

In early April, Medtronic entered into a "value-based outcomes agreement" with Blue Cross Blue Shield of Minnesota, and the two organizations have agreed to use a metric other than the gold standard A1C test to measure members' success using the device. A Medtronic spokeswoman recently told Diabetes Mine that Guardian Connect has become the first-ever stand-alone CGM using "Time in Range" as the key metric. Many advocates and innovators in the diabetes community have been pushing to move "beyond A1C.”

Medtronic's press release about their "Time in Range" metric explains:

"Time in Range (TIR) is a standard measurement in diabetes management that tracks the amount of time a person’s glucose is in their target range with 70-180 mg/dL being the standard range. Spending more Time in Range helps minimize both short- and long-term health complications from going too high or low. Results from an analysis of people who used the predictive alerts feature on the Guardian Connect system showed that they experienced fewer high events 39 percent of the time (vs. 10% without alerts) and fewer low events 60% of the time (vs. 33% without alerts)."

Medtronic also has been promoting their Time in Range infographic:

Diabetes Mine explained how Medtronic's reimbursements will work with Blue Cross Blue Shield:

"With Blue Cross Blue Shield, they are actually tying insurance payments to the amount of time users spend in this healthy glucose range -- an approach known as "value-based payments." So if a Medtronic CGM user does not manage to stay in that ideal 70-180 mg/dL range for a certain amount of time when using the device, then Medtronic will actually pay back the cost to the insurance company."

Six New Changes to the Dexcom G6 App for Apple

Siri Assist – You can now ask Siri to read Dexcom G6 glucose readings aloud and display graphs directly on the lock screen.

More Followers – With an expanded Dexcom SHARE function, you can now share glucose readings with up to 10 people (in the past the max was five).

24-hour Sensor Expiration Reminder – The app now offers an automatic 24-hour reminder before it’s time to replace a sensor, in addition to the existing 2-hour and 6-hour reminders.

CLARITY App at Your Fingertips – You can now launch the Dexcom CLARITY app directly from the Dexcom G6 app for more retrospective glucose reports, rather than having to exit the G6 app and go into the separate CLARITY app.

Extra Integration – They've also added a feature allowing Google Fit to display Dexcom G6 data on a three-hour delay (this lag is a regulatory hurdle being discussed with FDA).

Apple Watch Feature – Users can also add an icon to check their glucose level when customizing the face of their Apple Watch Series 4. Unfortunately, Dexcom doesn't yet allow for direct-to-watch functionality; you still need the smartphone as the middleman between the CGM and Apple Watch.

This month is a great time to zero in on some of the ways we can keep our hearts healthy. This month, the National Heart, Lung, and Blood Institute has launched #OurHearts, an initiative to encourage everyone to adopt heart healthy behaviors, together. Studies show that if you join forces at home, at work, in your community, or online, you have a better chance of staying motivated.

Start with small steps:

Move more.

Remember - Some physical activity is better than none.

Aim for a healthy weight.

Choose - Heart healthy foods and regular exercise help you achieve and maintain a healthy weight.

Eat healthy foods.

Try - Find an eating plan that is successful for you and supports your diabetes management.

Quit smoking.

Ask - Your family and friends can support you in your efforts to become a non-smoker.

If not treated quickly, mild or moderate low blood sugar can become severe. Glucagon is a treatment for very low blood sugar (severe hypoglycemia) which may affect people with diabetes. Two new versions are hoping to hit the market soon (these would be the first new types of glucagon in more than six decades).

After years of research, Eli Lilly has created a glucagon version that you "puff up your nose" to quickly boost blood sugar. Last summer, Lilly filed its nasal, dry powder glucagon for regulatory review in both the U.S. and Europe.

Xeris Pharmaceuticals has created a glucagon emergency pen that requires no mixing or prep, with an FDA meeting set for June of this year. The Xeris glucagon rescue pen would be the first ready-to-use, room-temperature stable liquid glucagon in an auto-injector to treat severe hypoglycemia.

Fully disposable with no separate transmitter - after sensor wear is complete, the entire piece is thrown out and replaced

No fingersticks - like the Dexcom G6

Extended wear - approximately 14 days

Sends data straight to Smartphone - via Bluetooth

This information came from the diaTribe blog. According to diaTribe, "This sensor will be made widely available to people with diabetes who are on intensive insulin therapy (pumps or multiple daily injections) and those with type 2 diabetes on pills or no medication."

This is an exciting technology to look forward to for better diabetes management for more people. We'll keep you in the loop as more news emerges from Dexcom. To learn more about CGM options available today, call us at 866.779.8512, Option 2.

Since 2007, the blue circle logo has been used to raise awareness of diabetes and convey the unity of the global diabetes community. The combined strength of the diabetes community is the key element that has made this campaign so special. From the World Diabetes Day literature, "As we all know: to do nothing is no longer an option." The blue border of the circle reflects the color of the sky and the flag of the United Nations; the icon was originally developed for the campaign that resulted in the passage of United Nations Resolution 61/225 "World Diabetes Day."

I just learned about what a fascinating and inspiring man Earl Bakken was. He co-founded Medtronic in 1949 with the unassuming goal of repairing medical equipment. But in the mid-50s, a heart surgeon in Minneapolis asked Bakken to create a pacemaker that didn’t need to be plugged in, and a few weeks later, he had invented a wearable pacemaker powered by a battery. Mr. Bakken was an inventor from an early age, and his worked sustained him late into his life. Bakken died on October 21 at the age of 94, and back in 2010 he was using his second pacemaker and third or fourth insulin pump!

He worried that children no longer take gadgets apart. Even engineers “never get the sense of the actual object they’re designing on a screen,” he wrote. “They make faulty assumptions because they have never taken the real thing apart and put it back together again. They’ve never jiggled it in their hand, never gotten a feel for its density and heft, never lifted it to their nose and smelled it. What a pity for them—and maybe for the rest of us as well.”

We are thankful today to Medtronic Diabetes for providing insulin pump and CGM technology to many of our patients. Just like their founder, they are in the business of changing lives.

Diabetes Awareness Month 2018 starts today, and World Diabetes Day is celebrated globally on November 14 to raise awareness about both Type 1 and Type 2 diabetes! Here are some ideas about how to get involved from some of our favorite advocacy organizations!

Happy Halloween! We love this story… A pumpkin sale recently helped Ian, a six-year-old who lives with Type 1 diabetes, and his family raise money for a service dog to help him manage his disease. In Sand Lake, Michigan, the Christensen family used their annual pumpkin sale as a fundraiser this year – and as a result, Ian will have a service dog trained specially to help him in less than a year. Ian’s diabetes service dog will be trained to detect the subtle smells in his breath and alert Ian before dangerous blood sugar lows kick in. We are so happy for Ian and his family!

“The world would be a nicer place if everyone had the ability to love as unconditionally as a dog.” ― M.K. Clinton

More great news has been announced about CGM! The Dexcom G6 continuous glucose monitor (CGM) will be covered for Medicare beneficiaries, starting in early 2019. CGMs are DME items that provide critical information on blood glucose levels to help patients with diabetes better manage their disease. Coverage for therapeutic CGM includes certain beneficiaries who have either Type 1 or Type 2 diabetes and intensively manage their insulin.

The Dexcom G6 CGM shines because of the following advantages:

Zero fingersticks

Acetaminophen blocking to maintain accuracy while taking Tylenol

Smartphone app that allows data to be shared with family members, providers, and other members of a patient's care team

Super easy application device

Very small and discreet sensor

Integration with the tSlim:X2 insulin pump from Tandem Diabetes, which is also covered by Medicare

Researchers have developed a more precise and nuanced method for predicting risk of diabetes and cardiovascular disease than traditional body mass index (BMI) measurements. Scientists at Scripps Research have found a way to use molecular “signatures” from people with obesity to predict these risks. The authors of the study wrote, “While BMI correlates well and to a large extent with individual health outcomes, it does not have the sensitivity to identify outliers, some of which carry unique health consequences.”

The research is led by Amalio Telenti, MD, PhD, and shows that predictors of future diabetes and cardiovascular complications for an individual can be found among the body’s metabolites. Metabolites are molecules that all of us produce as we live, breathe, and eat. Scientists study the “metabolome,” which is a person’s collection of hundreds of metabolites. The metabolome creates specific signatures or combinations of variants that can indicate risk. "By looking at metabolome changes, we could identify individuals with a several-fold increase in their risk of developing of diabetes and cardiovascular disease over the ensuing years," says Telenti. Metabolome changes were not always associated with obesity – some people studied were lean but still at risk of disease.

This research looks like it will become a powerful tool for predicting and preventing diabetes and cardiovascular disease in the future. The study suggests that new technologies can broaden the way that scientists think about disease. You can learn a lot more about research related to molecular signatures by reading these two articles:

A professor at the University of Central Florida, Elizabeth Brisbois, is working to develop a cannula that can be left in place for as long as 30 days while effectively delivering insulin into the body. Cannulas are small tubes that are inserted beneath the skin to deliver insulin into the body as part of an insulin pump system. The cannula can either be part of the infusion set or attached to the actual insulin pump. Normally, over time, the body’s immune system attacks the cannula, with cells creating a film around the cannula that begins to inhibit proper insulin delivery. That is why infusion sets normally need to be changed every two to three days to reduce the risk of infection.

Brisbois’ goal is to create cannulas that have a lower risk of infection and inflammation, with reduced pain and inconvenience for patients. She and her team are developing cannulas that release nitric oxide, a molecule that can kill bacteria. Nitric oxide is also produced in the body to fight off germs and has an important role in wound healing.

This advance could significantly increase quality of life for people living with type 1 and type 2 diabetes. Brisbois and her team are funded by a recent grant from the JDRF and are collaborating with researchers at the University of Georgia. Learn more about the cannula research here.

Medicare now offers reimbursement for the Dexcom G5 Mobile System for members who have type 1 or type 2 diabetes and intensively manage their blood sugar levels with insulin.

Medicare members now have access to a life-changing therapy for managing diabetes -- CGM. At Healthy Living, we are so excited that we can now offer Dexcom continuous glucose monitoring (CGM) to people living with diabetes on Medicare. CGM provides many benefits to users, including fewer daily fingerpricks and better insights into blood sugar trends. Dexcom CGM systems also work in tandem with insulin pumps and are an excellent addition to any diabetes treatment plan for closer monitoring, improved metrics, and more precise dosing.

Healthy Living can provide CGM systems, associated diabetes supplies, insulin pumps, and pump supplies to Medicare members. It is worthwhile to find out more about these advanced technologies. By calling us and talking with our Insulin Pump & CGM Therapy Team, you can learn more about how CGM and insulin pumps work and how they can benefit your diabetes management. We will also run a no-cost insurance verification check for you to learn more about your coverage.

In August, a patent was published that potentially offers clues into Apple’s rumored non-invasive monitoring solution. Apple submitted a patent application in 2015 for “Reference switch architectures for noncontact sensing of substances,” a method by which an electronic device can be calibrated to measure the concentration of a particular substance in a given sample. This is an optical system that enables determination of the concentration of a target substance by applying light with known properties to a sample. Although the patent documentation does not specifically explain what substances this proposed system might be used for, it resonates with rumors that Apple is working on a non-invasive glucose monitoring solution for use in their Apple Watch. Learn more about the science behind Apple’s patent application at appleinsider.

Healthy Living provides leading continuous glucose monitoring (CGM) systems that monitor blood glucose levels in real time for Blue Cross Blue Shield, Health Alliance Plan of Michigan (HAP), Priority Health and Priority Health Advantage, and Medicare members. CGM helps people living with type 1 or type 2 diabetes make more informed treatment decisions that lead to better glycemic control. To learn more, call 866.779.8512 (option 2) to speak with a member of our Insulin Pump & CGM Therapy Team!

Comment on the new Michigan Medicaid proposal via email, phone, fax, or letter.

Share your experience and thoughts, and let your voice be heard! Michigan Medicaid has proposed a new policy that will allow coverage of continuous glucose monitors (CGM) for eligible members. Now is the time to review the proposed changes in Medicaid policies and procedures. Your comments are due soon — September 26, 2018.

The proposed effective date is December 1, 2018. Our Healthy Living team has already submitted a letter to Michigan Medicaid to express our support of continuous glucose monitoring therapy as a highly effective way to help people with diabetes manage their disease.

Recent studies have shown that proteins in saliva can reflect high blood sugar and associated disease processes in children and adolescents with uncontrolled type 1 diabetes. This means that a simple saliva sample could replace blood tests to assess and monitor diabetes and can provide this information long before the appearance of clinical symptoms. Read the article for in-depth information on the research.

Co-author of the study, Professor Heleni Vastardis of NKU Athens School of Dentistry, explains, “The signs of diabetic pathology are already in place way before manifestation of clinical complications." This testing mechanism could lead to better prediction and prevention of long-term complications of diabetes.

I absolutely love this news that we found about Quincy. He is a male koala living at the San Diego Zoo, who has been diagnosed with type 1 diabetes. Thanks to CGM technology, his life has dramatically changed for the better.

This article explains that, “Diabetes has rarely been documented in koalas, and animal care experts do not know what may have triggered this condition in Quincy.” As part of his treatment plan, the vets at the San Diego Zoo have teamed up with Dexcom to better manage Quincy’s blood sugar levels through the application of a continuous glucose monitoring system. Quincy is using the new Dexcom G6 CGM system.

Koalas normally sleep during the day and are mainly solitary animals. This system markedly increases Quincy’s quality of life because he can avoid pricks to his ears to check his blood sugar and can be disturbed less often overall. Instead, the sensor and transmitter placed on Quincy send his blood glucose levels in real time to a smart device monitored by his caretakers. Check out a video of Quincy and his vets in action.

We hope that Quincy's story helps promote a greater awareness of CGM therapy! If you are living with type 1 or type 2 diabetes and have commercial or Medicare insurance, you may qualify to begin CGM therapy. Reach out to our team at 866.779.8512 to learn more and start the enrollment process now.

Medtronic's Guardian Connect is composed of three key components: the sensor, a bluetooth transmitter that lasts a year, and a mobile app

We're excited to share that Healthy Living Medical Supply is now shipping the Medtronic Guardian Connect CGM system! This is a great technology option for any patient who is taking insulin via injections and who isn't quite ready for an insulin pump. Read more about the Guardian Connect CGM system at the Medtronic website.

What is CGM? CGM stands for Continuous Glucose Monitoring and is a small, half dollar sized device that goes on your body and measures blood sugar levels every five minutes or roughly 288 times per day.

What are the benefits of CGM?We've written about this here on our blog before, but in short CGM reduces the number of daily finger sticks while giving patients much greater insight into what is happening with their body's sugar levels. Medtronic Guardian Connect's stand alone CGM system takes readings every five minutes or 288 times throughout the day and night - this is significantly more information than is yielded through finger sticks alone.

4. Last but not least, Medtronic's Guardian Connect CGM system is significantly less expensive for the patient and health plan in comparison to the competition. Why? Because the transmitter lasts for one year, no receiver is needed, and a month's supply comes with five sensors for a total of 35 days of wear time. This means lower copays for patients, longer sensor wear time and a lower spend for the health plan.

Most major commercial insurances, including Blue Cross Blue Shield of Michigan and Health Alliance Plan of Michigan (HAP), will pay for CGM. Contact Healthy Living Medical Supply today at 866-779-8512 to learn more and to begin the easy enrollment process.

Michigan Residents: Keep your business local! Healthy Living Medical Supply is the only locally owned and operated diabetes speciality provider in the state of Michigan...and we provide world class customer service!

Recently, the Swing to Cure Diabetes golf outing celebrated its 10th anniversary at the Michigan Golf Course. As we have for several years, Healthy Living participated in this awesome event that benefits the JDRF and the Michigan Comprehensive Diabetes Center. Swing to Cure Diabetes was created by Rich and Chris Hewlett to help find a cure for Type 1 diabetes. They started the event after their son, Jeff, was diagnosed. These were Jeff’s thoughts on the event:

“I’m sure my parents started this event thinking, ‘Oh, this will help our son,’” said Jeff Hewlett, who was diagnosed when he was four. “For that I’m certainly grateful, but there are many people who are just like me and many other diabetics who are also grateful. It’s really impacting a lot of people, and you can see it in the research and the advances that have been made for Type 1 diabetes. Hopefully over the years as this thing keeps growing and as we continue with it, it will be something that can hopefully lead to a cure. That’s ultimately what we’re looking for.”